Electronic Communication Consent Form
An electronic communication consent form is used to gather permission from clients or patients to transfer information electronically. Whether you’re a physician or a dentist, this free Electronic Communication Consent Form will make it easier to outline the security risks for your patients and obtain informed consent via electronic signatures. Simply customize the form to meet your needs and email it to patients — they can read your terms and conditions, answer questions, and provide their e-signatures from any device. You’ll instantly receive submissions in your secure Jotform account, protected according to HIPAA standards if you have an upgraded plan — or for free if you’re eligible for our Coronavirus Responder Program.
Customize your Electronic Communication Consent Form with our drag-and-drop Form Builder. Make sure your patients understand the security risks of electronic communication by including your clinic’s specific terms and conditions. Without any coding, you can add more form fields and text, change the template design, and integrate with 100+ apps to automatically sync submissions to your other online accounts. When you’re done customizing, publish it on your website or send a private form link to your patients. With a custom Electronic Communication Consent Form, your healthcare organization can ensure that patients understand and accept the risks of electronic communication before receiving treatment.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.
